TY - JOUR ID - TI - The Effectiveness of Tramadol in Treatment of Premature Ejaculation on-Demand Basis AU - Montadhar H. Nima AU - Samir Ali Muter AU - Ahmed Samir Al-Naaimi AU - Nibbras I. Al-Hamdani PY - 2013 VL - 12 IS - 3 SP - 429 EP - 435 JO - Iraqi Postgraduate Medical Journal المجلة العراقية للاختصاصات الطبية SN - 83601608 98932708 AB - ABSTRACT: *Department of Surgery, College of Medicine, University of Baghdad.**Department of Surgery, College of Medicine, University of Baghdad.***Department of Community Medicine, College of Medicine, University of Baghdad.****Consultant Urologist, Baghdad Medical City. BACKGROUND: Premature ejaculation (PE) is a worldwide problem. Selective serotonin reuptake inhibitors (SSRIs) arewidely used “off label” as pharmacotherapeutic agents in the treatment of PE. OBJECTIVE: Assess the efficacy of Tramadol for on-demand treatment of PE. PATIENTS AND METHODS: During the period December 2008 through November 2009, 60 married men visited the surgicalspecialties hospital urology outpatient and consultancy clinics complaining of premature ejaculationwere enrolled in this study. Intravaginal ejaculation latency time (IVELT) was used as an objective toolto assess the efficacy of the investigated treatment. Single-blind, placebo-controlled therapeutic trialwas conducted on 60 patients with lifelong PE. PE was defined as IVELT of <2 minutes in at least 80%of intercourse episodes. The patients cohort was randomised into 2 equal sized groups. The interventiongroup (n=30) used 50 mg tablet of Tramadol hydrochloride, while the control group (n=30) used aplacebo tablet for 8 weeks. Drugs were taken 1–2 hours before sexual activity, and sexual intercoursewas required at least once per week. IVELT was timed by a stopwatch at each intercourse. RESULTS: The mean IVELT after tramadol and placebo significantly increased from 73.1 and 67.9 seconds toapproximately 442.1 and 113.3 seconds, respectively (P < 0.001). Sexual satisfaction was used to assessthe cut-off values of IVELT in defining the minimal and best clinical response to treatment. There wasno withdrawal symptoms recorded following the use of tramadol or placebo, but more adverse eventswere associated with tramadol treatment CONCLUSION: Tramadol seems to provide significantly better results in terms of IVELT and intercourse satisfactionversus placebo. Further studies are required to draw final conclusions on the efficacy of this drug inpremature ejaculation

ER -